# US 8,543,203 B2 · Endocardial pacing devices and methods useful for resynchronization and defibrillation > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,543,203 B2 - Document ID: US8543203B2 - Status: Granted - Kind: B2 - Application number: 13/211,937 - Filed: 2011-08-17 - Published: 2012-02-16 - Granted: 2013-09-24 - Earliest claimed: 2004-12-20 - Assignees: Cardiac Pacemakers, Inc. - Applicants: Qingsheng Zhu; Daniel Felipe Ortega - Inventors: Qingsheng Zhu; Daniel Felipe Ortega - Web page: https://patentgrep.com/patent/US8543203B2 ## CPC - A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy} - A61N 1/39622: {Pacing therapy} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract According to one aspect, various methods and apparatus are used for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement is placed in a right ventricle of the heart. The electrode arrangement is used to capture the myocardium for re-synchronization of the left and right ventricles by providing first and second signal components having opposite polarity on respective electrodes. The electrode arrangement is connected to an implantable CRM device that has the capability of pacing/sensing atrium, pacing/sensing ventricles, and deliver defibrillation therapy from the right side of the heart. The CRM device captures ventricular contractions to treat conduction abnormalities in one or more of the ventricles. ## Claims ### Claim 1 An implantable medical device comprising: an electrostimulation circuit configured to: generate at least partially concurrent electrostimulation pulses of opposing polarity to be delivered via electrodes positioned at a target region at or near a bundle of His in a right ventricle of a heart, the electrostimulation pulses including at least two pulses occurring sufficiently proximate one another in at least one of time or distance to elicit myocardium capture near the target region at or near the bundle of His; and generate a defibrillation signal. ### Claim 2 (depends on 1) The implantable medical device of claim 1, further comprising an implantable lead assembly including a first electrode and a second electrode; and wherein the electrostimulation circuit is configured to generate two electrostimulation pulses including a first pulse configured to be delivered via the first electrode and a second pulse configured to be delivered via the second electrode. ### Claim 3 (depends on 2) The implantable medical device of claim 2, comprising a third electrode configured to be positioned in the right ventricle, and wherein the electrostimulation circuit is configured to deliver the defibrillation signal via the third electrode. ### Claim 4 (depends on 2) The implantable medical device of claim 2, wherein the first pulse and the second pulse include respective portions that are at least partially concurrent in time. ### Claim 5 (depends on 4) The implantable medical device of claim 4, wherein one or more of the first pulse or the second pulse includes a biphasic waveform. ### Claim 6 (depends on 5) The implantable medical device of claim 5, wherein the electrostimulation circuit is configured to generate an electrostimulation pulse including a reversed pulse polarity once every N beats. ### Claim 7 (depends on 1) The implantable medical device of claim 1, wherein the electrostimulation circuit is configured to generate the defibrillation signal in response to obtained information indicative of a tachyarrhythmia, the information obtained via an electrode positioned in the right ventricle of the heart. ### Claim 8 A method comprising: generating at least partially concurrent electrostimulation pulses of opposing polarity to be delivered via electrodes positioned at a target region at or near the bundle of His in a right ventricle of a heart, the electrostimulation pulses including at least two pulses occurring sufficiently proximate one another in at least one of time or distance to elicit myocardium capture near the target region at or near the bundle of His; and generating a defibrillation signal in response to a sensed signal indicating the heart is in a defibrillation. ### Claim 9 (depends on 8) The method of claim 8, wherein generating the two pulses includes generating a first pulse configured to be delivered via a first electrode and a second pulse configured to be delivered via a second electrode. ### Claim 10 (depends on 9) The method of claim 9, comprising delivering the defibrillation signal to a third electrode positioned in the right ventricle. ### Claim 11 (depends on 9) The method of claim 9, wherein the first pulse and the second pulse include respective portions that are at least partially concurrent in time. ### Claim 12 (depends on 11) The method of claim 11, wherein one or more of the first pulse or the second pulse includes a biphasic waveform. ### Claim 13 (depends on 12) The method of claim 12, wherein generating the pulses includes generating an electrostimulation pulse including a reversed pulse polarity once every N beats. ### Claim 14 (depends on 8) The method of claim 8, comprising obtaining information indicative of a tachyarrhythmia via an electrode positioned in the right ventricle of the heart; and wherein generating the defibrillation signal includes generating the defibrillation signal in response to the obtained information indicative of the tachyarrhythmia. ### Claim 15 A processor-readable medium, including instructions that, when performed by a processor, cause the processor to: generate at least partially concurrent electrostimulation pulses of opposing polarity to be delivered via electrodes positioned at a target region at or near the bundle of His in a right ventricle of a heart, the electrostimulation pulses including at least two pulses occurring sufficiently proximate one another in at least one of time or distance to elicit myocardium capture near the target region at or near the bundle of His; and generate a defibrillation signal in response to a sensed signal indicating the heart is in a defibrillation. ### Claim 16 (depends on 15) The processor-readable medium of claim 15, wherein the instructions that cause the processor to generate the electrostimulation pulses include instructions to generate a first pulse configured to be delivered via a first electrode and a second pulse configured to be delivered via a second electrode. ### Claim 17 (depends on 16) The processor-readable medium of claim 16, wherein the instructions that cause the processor to generate the defibrillation signal include instructions to generate a defibrillation signal to be delivered via a third electrode positioned in the right ventricle. ### Claim 18 (depends on 16) The processor-readable medium of claim 16, wherein the first pulse and the second pulse include respective portions that are at least partially concurrent in time. ### Claim 19 (depends on 18) The processor-readable medium of claim 18, wherein one or more of the first pulse or the second pulse includes a biphasic waveform. ### Claim 20 (depends on 19) The processor-readable medium of claim 19, wherein the instructions that cause the processor to generate the electrostimulation pulses include instructions to generate an electrostimulation pulse including a reversed pulse polarity once every N beats. ### Claim 21 (depends on 15) The processor-readable medium of claim 15, wherein the instructions that cause the processor to generate the defibrillation signal include instructions to generate the defibrillation signal in response to obtained information indicative of a tachyarrhythmia, the information obtained via an electrode positioned in the right ventricle of the heart.